Background/Purpose: In Rheumatoid Arthritis (RA), sustained remission is associated with less disability ^(1,2) , and this outcome should be the goal in the RA treatment; however, there are scarce of data about the impact of prolonged remission in health-related quality of life (HRQoL) in RA patients in our region. The aim of this study is to determine the impact of time under remission in to achieve a better HRQol status in RA

Methods: Prospective study in a RA cohort from a single center. Subjects with at least two visits performed, were included. Visits were performed every six months; socio-demographic, clinical data (including disease activity status) and HRQol measured by the 36-Item Short Form Health Survey questionnaire(SF36), were recorded in each visit. Remission and low disease activity (LDA) statuses were defined as Clinical Disease Activity Index (CDAI) definition(<2.8 and 2.9-10, respectively) and time in remission was categorized in percentiles of time (>50, >25% and ≤50%, and ≤25%) in remission. The outcome was the value of each SF36 component and domain at the final visit. Univariable and multivariable lineal regression models, adjusted by age at diagnosis, disease duration, treatment [use of corticosteroid, synthetic(s) and biologic (b) Disease Modifying Rheumatic Drugs (DMARDs)], time of follow up and each baseline SF36 component or domain were performed in order to determine the associations.

Results: Four hundred nine patients were included; 369 (90.2%) were female, age at diagnosis was 44.49 (13.84)years and disease duration at baseline was 16.57(11.50) years. sDMARDs and bDMARDs were used at baseline by 58,7% and 9.5% respectively. The mean follow-up was 1.39(0.49) years. Percentage of time under remission and LDA status during the follow up were 13.33(26.39)and 49.61(39.16)respectively. In the multivariable analysws the better percentile under remission (>50%) predicted a better HQol performance in the Physical Component Summary(PCS): B=0.170(0.705-1.635);P<0.001, and in the following components: physical functioning [B=0.078; (0.033; 0.122); p<0.001], role physical [B=0.215 (0.163-0.267); p<0.001], body image [B=0.293; (0.251-0.335); p<0.001]; global health [B=0.127 (0.083-0.171);p=0.001]; role emotional [B=0.184 (0.126-0.242); p<0.001]; mental health [B=0.051; (0.011-0.091); p=0.012]. There were not statistically significant associations with the other component and domains.

Conclusion: A more prolonged time under remission predicted a better HQol status in our RA patients. Prolonged remission in addition with sustained remission could be a treatment goal to avoid disability.

(1). Einarson JT. J Rheumatol. 2016;43(6):1017-23. (2). Ma MHY. Clin Exp Rheumatol. 2018; 36(2):203-209

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/a-more-time-under-remission-impacts-in-a-better-health-related-quality-of-life-in-rheumatoid-arthritis-mestizo-population/